Qualified status change

Under the Health Insurance Portability and Accountability Act (HIPAA), specific life events allow you to make changes to your health insurance coverage outside of the regular open enrollment period.

Special enrollment events include:

  • Your marriage or establishment of your domestic partnership

  • The birth or legal adoption (or placement for adoption) of a child, or a child of your domestic partner

  • You or your eligible dependent becomes eligible for assistance under Medicaid or a state child health plan

  • The loss of other health coverage by you or your eligible dependent, due to one of these scenarios:

    • The exhaustion of COBRA coverage

    • The loss of eligibility due to change in employment

    • The end of employer contributions, resulting in a higher cost of coverage

    • The loss of eligibility for coverage under Medicaid or a state child health plan

Important Note: Though not required by HIPAA, Microsoft allows equivalent arrangements for domestic partners and their children if they are otherwise eligible for coverage. 

If you experience a special enrollment event, you may make the following changes, as long as these changes are due to and consistent with the reason for the status change: 

  • Add medical, dental and/or vision coverage for yourself or your eligible dependents

  • Change medical coverage options 

  • Begin, increase, decrease, or end participation in the flexible spending accounts (FSAs). (If you increase your FSA contribution, you may not be reimbursed for eligible expenses beyond your prior contribution if they occurred before the change.) 

  • Add or delete dependent life insurance coverage 

  • Add or delete dependent accidental death and dismemberment (AD&D) coverage if you are currently enrolled. (The amount of employee AD&D coverage cannot be changed.) 

Changes are not permitted for employee life insurance, long-term disability, group legal or Perks+ outside of the annual open enrollment period. 

If you experience any of the following life events, you may be eligible to make limited benefit changes for yourself or your eligible dependents:

  • A divorce, legal separation, or an annulment, or the dissolution of your domestic partnership
  • The death of an eligible dependent
  • A change for dependent child’s status such that they satisfy, or no longer satisfy, the requirements for dependent status
  • A change in employment for you or your spouse/domestic partner, even if this change does not affect your eligibility for coverage (gain or loss of job, change in hours worked, taking or returning from unpaid leave)
  • A change of residence for you or your eligible dependent (for example, an interstate transfer that results in a change of eligibility for a medical plan)
  • You or your eligible dependent becomes eligible for Medicare or Medicaid
  • The issuance of a qualified medical child support order (QMCSO) with respect to the health coverage for your eligible dependent child 
  • A significant change in dependent care cost or coverage for you or your spouse/domestic partner 

Important Note: You are required to make a benefit change in the case of a divorce, legal separation, annulment, or the dissolution of your domestic partnership. 

If you experience one of these other life events listed above, you may make the following changes, if these changes are due to and consistent with the reason for the status change: 

  • Add medical, dental, and/or vision coverage for yourself 

  • Add or delete medical, dental, and/or vision coverage for your eligible dependents 

  • Begin, increase, decrease, or end participation in the flexible spending account (FSA). (If you increase your FSA contribution, you may not be reimbursed for eligible expenses beyond your prior contribution if they occurred before the change.) 

  • Add or delete dependent life insurance coverage 

  • Add or delete dependent accidental death and dismemberment (AD&D) coverage if you are currently enrolled. (The amount of employee AD&D coverage cannot be changed.)

Note: In addition to the rules above, if you are in a domestic partnership, you may make changes to the dependent care or health care FSA if the change in status affects you or your child or children, but not if the change in status affects your domestic partner or your domestic partner's child or children.

The benefit changes you make must be due to and consistent with the reason for the status change.  Here are some examples: 

Jodi's (a Microsoft employee) family is covered by benefits through their spouse's employer. If their spouse loses their job, Jodi may make the following changes to their Microsoft benefits: 

  • Enroll or change coverage in medical and dental 

  • Enroll, change or stop coverage in the health care FSA 

  • Change or stop coverage in the dependent care FSA 

  • Enroll, change or stop spouse life insurance coverage. Enroll for child life insurance if not previously enrolled 

  • Enroll or increase dependent AD&D coverage 

Terika and their partner have a baby. Terika may make the following changes to their benefits: 

  • Enroll or change medical plans, and add dependents 

  • Enroll in dental, and add dependents 

  • Enroll, increase or stop coverage in the health care FSA 

  • Enroll or increase coverage in the dependent care FSA 

  • Enroll for child life insurance if not previously enrolled (They cannot remove current child life coverage or change the level of coverage) 

  • Enroll for dependent AD&D coverage (They cannot change the level of coverage if already enrolled) 

Joe contributes to the dependent care flexible spending account (FSA) for their spouse's son. If Joe's spouse changes from full-time to part-time work, and loses eligibility for medical and dental coverage, Joe can: 

  • Change their contribution to the dependent care FSA 

  • Enroll or add dependents to the medical, dental, and/or vision plans 

  • Enroll or increase health care FSA coverage

The amount of time you have to make an enrollment change as a result of a life event depends on the qualifying status change. It is very important to make your change during this window or you’ll have to wait until the next annual open enrollment period to make a change. Changes made during the annual open enrollment period become effective January 1st of the year following the open enrollment period. 

Qualifying event

Make changes within

Birth of a child

90 days

Legal marriage or initiation of a domestic partnership

90 days

Divorce or legal separation

60 days

Termination of a domestic partnership

60 days

Death of a covered dependent

30 days

Loss of a job by your spouse/domestic partner

30 days